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PW-10-1022Inspection Number: INSP - 145057 Scheduled Inspection Date: August 16, 2010 Inspector: Bruhn, Norman Owner: SHORES VILLAGE, MIAMI Job Address: 9250 Bayshore Drive Pump Station Miami Shores, FL 33138 -0000 Project: <NONE> Contractor: L&H ELECTRIC INC Building Department Comments ELECTRICAL MODIFICATIONS TO A PUMP STATION AT BAYSHORE DRIVE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 13, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: PW -6 -10 -1022 Permit Type: Public Works Inspection Type: Final Work Classification: Public Works Phone Number Parcel Number 305/751-1271 PUMP STATION Phone: (305)557 -5558 Page 3 of 26 ELECTRICAL MODIFICATIONS TO A PUMP STATION AT BAYSHORE DRIVE Passed Inspector Comments PLEASE CALL 305 - 888 -6541 OR 305 - 510 -8118 f `4/ ../Z----) 'w / f � � ��j��(Y Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 I nspection Number: INSP - 150132 Permit Number: PW -6 -10 -1022 Inspection Date: August 16, 2010 Inspector: Devaney, Michael Owner: SHORES VILLAGE, MIAMI Job Address: 9250 Bayshore Drive Pump Station Project <NONE> Miami Shores, FL 33138 -0000 Contractor: L&H ELECTRIC INC Building Department Comments August 16, 2010 For Inspections please call: (305)762 -4949 Permit Type: Public Works Inspection Type: Final Work Classification: Public Works Phone Number Parcel Number 305/751 -1271 PUMP STATION Phone: (305)557 -5558 Page 1 of 1 1l rc k Miami Shores Village Building Department BUILDING Permit No.Wi — 02, PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: Electrical OWNER Name (Fee Simple Titleholder): Pi I MM i O) 4 \1(# D Phone#: ` ` 3 N Address: 119 OS 0 �'''"Y rQ,�, 3 City: I MItkv4, Sic QS State: L. Zip: 3 1 '6 9 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: q 1 T12 1'r ea v $ 9 a. t .Q e t r t°1. z- ' ZL City: .NEami Shores 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER (305) 762.4949 County: Miami Dade Zip: ImaNnwsn BY:...! Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR Company Name: L k 't 1 c 4'+ n! L n (. Phone#: 3S S S s S$ Address: ol. ‘ { I q 4 j1" \ 3 ti City: 1 : \ Gh\ 4 ,kA l G (LT-3 v S State: Zip: 3 0 Qualifier Name: I C in n e Q ._ Phone#::? 0 c--3O) _ 36 Y 3 State Certification or Registration #: E C-. ZJ MO (r . 11 Certificate of Competency #: Q t) ©! (1;2. Contact Phone#: N ! (In1Q1 1. DPS.0 W.,_. Email Address: h'), / o 5 C.19la Q 1 b 2 C o W\ DESIGNER Architect/Engineer: Phone#: Value of Work for this Permit $ ` 1 y®,/ ear Footage of Work: Type of Work: ()Address ifAlteration ew ❑Repair/Replace ()Demolition Description of Work: E 1 e fs* UC i --Son pvJ M p 9k c ' — tee C r 6 k. sse+ **r**** **ere ***** *ev*r*********eeaeF **** *n ape **********ees *s *bs **** ** ****eae+aes» Submittal Fee Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ B6►nding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged '`P o Signature Signature Owner or Agent Contractor The f instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day o , 20 IQ by , day of .J) N , 20 /12, by 14 (roil et. 7) .to eSc - who is personally known to me or who has produced who i pe sonally know me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY NOTARY ' LIC: ca Sign: Y ! � ,N. Print: r ` , , N.- e^ , v O y�����11y+ ' (.., e,.. My My Co 7 '4.' saO APPROVED BY 1 / ./ ..? ✓CA' «Plans Examiner Zoning My Commission Expires: Structural Review Clerk (Revised (7 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Sign: Print Public Works Permit Application FBC 2004 Permit Typo: Public Works WATERM d oes Owners Name (Fee Simple Titleholder) '' `` Owners Address l 00Sb N E- Job Address (where the work is being done) City Miami Stores Village Is Building Historically Designated: Contractors Company Name Contractors Address City Architect/Engineers Name (if appfbable) $ Value of Work For this Permit Type of Work Describe Work Submittal Fee $ Notary $ Scanning $ Code Enforcement $ Total Fee Now Due S (Continued on opposite side) Miami Shores Village Public Works Department "FP L. ❑ Addtlion 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 YES M State City h •k`. SitL ' S VILU a state r-t- Radon's Structural ural Plan Review S Phi #: p.mittioM - 1022, #as- - Rs - TenanULessee Name Phone ft Phone t zip ‘ 311c3 S Zip ZIP Lineal Footage Of Work ❑ Now ❑ Repair/Replace 0 Demo66on CCF S CO/CC Technology Fee $ Zoning Bond S Bonding Company's Name (if applicable) Bonding CoMpany's Address WA City State Mortgage Lender's Name (if applicable) WA Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC .... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant As a condition to this issuance of a Public Works permit with'an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site for the fast inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection tee will be charged. Signature Signature NOTARY PUBUC: My Commission Expires: APPUCATION APPROVED BY: 11/17/2005 Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by day of , 20 _, by who is personally known to me or who has produced Who is personally know to me or has produced as identification ation and who did take an oath. as identification and who dad take an oath. 'NOTARY PUBUC: Sign: Sign: Print: Print My Commission Expires: Public Works Director or his designee. Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 9250 Bayshore Drive Number: Pump Statior PUMP STATION Miami Shores, FL 33138 -0000 Block: Lot: MIAMI SHORES VILLAGE Owner Information Address VED Expiration: 09/23/2010 Parcel Number Phone MIAMI SHORES VILLAGE 10050 NE 2 Avenue MIAMI SHORES FL 33138 -2304 305/751 -1271 1 Contractor(s) L &H ELECTRIC INC Phone CeII Phone (305)557 -5558 Scanning: 1 Fees Due Permit Fee Scanning Fee Total: Amount $o.00 $o.00 $0.00 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Pay Date Pay Type Amt Paid Amt Due Invoice # PW -6 -10 -38083 $ 0.00 Applicant Valuation: Total Sq Feet: $ 0.00 0 1 Date Cell Available Inspections: Inspection Type: Final Excavation In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. June 25, 2010 June 25, 2010 1 Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Address Contractor(s) L&H ELECTRIC INC Phone Cell Phone (305)557 -5558 Type P !b1 /j fl Pul Parcel Number 9250 Bayshore Drive Number: Pump Station PUMP STATION Miami Shores, FL 33138 -0000 Block: Lot: MIAMI SHORES VILLAGE 1 Phone MIAMI SHORES VILLAGE 10050 NE 2 Avenue MIAMI SHORES FL 33138 -2304 305/751 -1271 1 Scanning: 1 Fees Due Permit Fee Scanning Fee Total: Amount $o.00 $o.00 $0.00 Pay Date Pay Type Amt Paid Amt Due Invoice # PW -6 -10 -38083 $ 0.00 Applicant CeII Valuation: Total Sq Feet: $ 0.0 0 Available Inspections: Applicant Copy For Inspections, Call (305) 795 -2204. Requests must be received by 3 pm for following day inspections. Inspection Type: Final Excavation 1 NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. June 25, 2010 2 • 3 INDEX OF DRAWINGS SHEET NO DESCRIPSIGIt 1 COVER SHEET 2 ELECTRICAL MODIFICATIONS SITE PLAN AND DETAILS APPROVED ZONING DEPT BLDG DEPT DATE SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COI INTY RULES AND REGULATIONS J qt - Miami Shores Village MIAMI SHORE VILLAGE BAYSHORE DRIVE PUMP STATION ELECTRICAL MODIFICATIONS ELECTRICAL LEGEND, ABBREVIATIONS, AND NOTES RISER DIAGRAM AND DETAILS „ • L u r - ■ ) rt-A, A11 '••*•• illiim-11111IiiiienrAmvp.rtrfi NI me ____Iormarmarmurwmm No waillWm. 111 Irwiewmplir , , .ismomrsrwv Ima orminui. 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ROSS 201 ALHAMBRA CIRCLE • SUITE 900 • CORM- GABLES, FLORIDA 33134 PliC44E: (305)407-1SW • FAX: (305)487-1271 8300000407 DICIESSIEMIla.2010 018%ErsEPILMMa PUL BOX MIND DETAIL ass CONTBOLLER • ' manna) isusisrossreR LOCATION FOR PAO A . = • IDERCEPT oast uo. cottourr. MULL PULL BOX MM ) • .■ REARM FEEDERS FROM ilek„ PloW • - 0 . "‘ STATION PUMP STATION ELECTRICAL MODIFICATIONS 0 0 1 COMPOTIft. ES:0060 *ma 2 ELECTRICAL NOTES: 1. ALL ELECTRICAL WOW SHALL BE IN ACCORDANCE WITH ME NATIONAL ELECTRICAL 000E AND ALL APPLICABLE LOCAL CODES. 2. THE CONTRACTOR TU L DAME ME JOB SITE AND 0670011107 FOR HIMSELF 08408 TO SO8105SIO/ OF 840. RUSTING CONDITIONS. 1 ALL ELECTRICAL NOR( SHALL 80 PERFORMED BY A Medal EIECIRICAL CONTRACTOR. R 111. BE 503 0050044 0470 TO 50005E AND PAT FOR ANY PERMS, CERTIFICATES OF INSPECTION, ETC. suasnrun MATERIALS. MIGRANT OR METHODS SHALL Nor BE MADE 6MOD7 APPROVAL OF DC ENGINEER. 7 THE USE OF A SUBSTITUTE 04ANGE NOM THE NECESSITY FOR SuCH CrioNSE wit RECILAREs BE BROUGN1� TO THE ATTENITON OF TS ENGINEER. AND S APPROVED. SHALL BE MADE AT NO COST 70 THE OWNER. 2. CLEAN UP SUCH TRASH AID OE8MMS GENERATED BY THE TRILL( AND LEAVE COMPLETED WORN 04 A CLEAN. UND i0EO. AND FINISHED 000408101) READY TO RECEIVE 111UIOIT FURTHER PREPARA760i. MESS SO SPE01E0 IN OMER SECTIONS, ANY A1ACENT OR ABUTTI C WOW TO 8E PERFORATED BY OTHERS. 6. W7ERIALS. APPUAS.FS, 064TCE4 AND ECU2+MENT RVN4. MEET WNM 08 IEOARF00475 OF 08000847089' LABORATORIES AND SHALL BE NEW AND NE LATEST STANDARD PRODUCTS OF MANUFACTURERS REGIAJALY ENGAGED 84 THE PRODUCTION OF THE HEY. UNLESS 016088E WOICATER UA7E ITEMS SHAT BE ME PRODUCT OF A 4NGLE MANUFACTURER. 7. pLL CONDUCTORS SHALL SE COPPER AND RUN IN CONDUIT. 1100 920 SHALL BE pI2 ARO MIN., MTN. UNLESS 0114ER7OSE NOTED ON PLANS. PROVIDE 0R0O1) CONDUCTOR PER NEC 250 -95 00 NOT SHARE NEUTRALS. RUN A NEUTRAL 100 FOR EACH OR004T. 8. PROMISE TYPEWPoTIOI ScHE0ULE4 FOR ALL PAEI.BOAR05. PROVIDE IUWEPLAIES FOR ALL ELECTRICAL DOWNER' B. PROJECT. THESE PLANS ARE O OAORAA MATIC N CHARACTER IMO MY 41985 O®1 ARE =was 1ECESSAW/ MP THE 074104.71984 OF THE 4OOi SHOO. BE COED A PORTION OF THE TORII EVEN THOUGH 4401 DIRECTLY SPECIFIED OR 94941 ON THIS DRAWING AND SHAT FIE ROMEO. IQ AND CONNECTION TO AL EQUIPMENT FURNISHED fff OTHERS. PRIOR 10 86TALI9IG THE amc1ECAL SYSTEM. 11. EIEC718CM. INSGUER OR SUBCONTRACTOR SHAT HE RESPONSIBLE FOR 47114 COORLRATION OF HIS WORK WITH GENERAL. CONTRACTOR AND OTHER SUBCONTRACTORS. 12. AU. CONTROL WINO WALL 80 NNE RESPONSIBILITY OF THE IECNABCAL SURXWITRACTOR. MECHANICAL 5060004060101470 PIMP CONTROL PANELS AND PIMP ORES 41 RNAL COWECDONS TO (04474 47 SHALL BE PER YANOFACTIRER'S APPROVED PROD DIAGRAMS 867045. APO 2451RUC1ONS. 14. SUBMIT SHOP ORRANOS OF ALL E1ECR8CAL EQUIPMENT TO ENGINEER. 3 ig•80 ❑ - POWER EQUIPMENT LEGEND ® REcramAL 4RWFn [E] rASt 8Aa4NOL BOX. 512E-0 FUSED SAFELY 5WR01- 3PONE.SOMP FROM 20 AP FUSE 0004760 -0 FUSE SIZE INO ED GI1E4 NON -FUSED -4 , 480 VOLTS 010CA6E0 FUSE BY MANTEL NAME PLATE OR AS NOTED STARTER, SOl 24D'CAED MOTOR -ILP. 000409E UPN PULL BOX © MAC- BE4G1AION 81088 ® mason WATTAGE SUPPRESSOR ❑ ELECTRICAL EO4PMENT. AS CN PLANS 002016IED. • DUPLEX 67000ACLE FLOORS CONDUIT CONCEALED COHORT EAPOSEO COMM UNDEAOt01ID CONDUIT 0101000 HOE. CAPPED CONDUIT =-3 -- GRCFID CONNECTION ABBRBAATICWS OF ABOVE P849ED FLOOR RC TOPERS OBERRIQ)DD CURRENT 018 124708090 18410S7E8 546401 C CONDUIT 08 maw WEAKER OCT CIRCUIT CON CONNECT OR CONNECTION CU COPPER OOQ 00011800 EC ROSY CONDUIT ELECT 64*0 RICA. W HORSE 000408 00 44160TIO1 BOX KYA 940 VII - 49060E MOO YO70R CONTROL CENTER W YA0000 8B) MOWED MOM CESCIFIFMOM 08 EMERGENCY 00 0X01147000 WELD EGET EXISTING RI FLOW SWIM OR OROSD FAU2.7 OTERRUPIER O D GROUND ORS OALVAN92 0 RICO STEEL HOWL HAND - OFF - AUTOMATIC T TRANSFORMER Y WET 181 WIDER GROUND VA VOLT- AMPERE 4P NEARER PROOF 1047 NEUTRAL TOTE OVER crone PROTECTIVE (LOAM 08 PUSS FRRTCU4JU.80X PB PHOTOREC490 CELL PH PHASE PL PILOT LIGHT M. PANE. BIN WR7CH SKR SOUTH FLORIDA WATER MANAGEMENT RIM CA1 44ARIN NOHP 2 -1410 4404000 O 21 0444 480V1 21 X 4001 , 1.25 K 21 X 4801. 39.3 KVA 5 KVA 4000. LOADS a }8 KYA 44.3 KVA }gjQU, 407 NOS C 240V, 7P co0SANGr, mI1204.m THE POUCIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH I MIS cot 1 II-IL A 1 k MAY Olt ISSIUbU OM MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED H$,REIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C . AI � M Y S �F��� V 1YI+F- up nnwHAN4b PUUI:T NUMOtR ���! P OR I TC ln7RlIOOITTI (���(, P DZ1xE,l API AXON UMIT3 A GENENAL X ._1_ _ MIN LIABILITY COMMERCIAL GENERAL LIABILITY - I own MADE [ ..... 1 OCCUR ._.. _............. --. _.._. -. I. AOGRFGATE LIMIT APPLIE PER: I POLICY I - - I JECT I I LOC C1 L - 42570-03 8/27/10 10 8/27/11 1 1 �^ EACH OCCURRENCE 8 2,000,000 FIRE DAMAGE (Any one ere) 50,,000 +—mob- MEO EXP (Any one perso b 1.000 PERSONAL II ADV INJ 2,000,000 s 2.000.000 , s OPJGDA'. er,LserfgATn PRODUCTS - COMMA AGO g 2,000.000 b AUTOMOBILE _... • LIABILITY ANY AUTO ALL OWNER AUTOS SCHEDULED AUTOS HIRFO AUTOR NON -OWNED AU I'OS " - .----- COMBINED SINGLE LIMIT (Ea acgdenl) b OODILT INJURY (Pei pow) b OBI) Y INN IL1RY Pnr naaidnn�) 8 - ' PROPERTY UAMAOE (PCT ecNdenl) Au10 ONLY - EA ACCIDENT 8 ) b GARAGE 1 L=MCESS LIABILITY ANY AUTO 1 OTHER THAN ACC AUTO ONLY: A00 a LIABIUTY I OCCUR ri CLAIMS MADE DEDUCTIBLE RETENTION C EAC H OCCURRENCE 8 - AGGREGATE b S d S .�...._.- • 8 li WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 19603395 I/1/10 1 / 1 / 11 1 TORM 1 IS" E L CAQH ACCIDENT b 1,000,000 C.L. DISEASE - EA EMPLOYEE 4000,000 E.L DISEASE - POLICY LIMIT M S 1,000,000 OTHER gf•,$CRIPTION OP OPERATIONQILOOATIONW VEHICLEC ENCLU310N0 AOOf10 BY CNOOROCMCf T/3PCCIAL Pr1OVIOIO140 • ELECTRIC CONTRACTOR ACORD. CERTIFICATE OF LIP BILITY INSURANCE PRODUCER QUANTUM INSURANCE GROUP 5740 HOLLYWOOD BLVD., SUITE 104 HOLLYWOOD, FL 33021 INSURED L & 14 ELEC'T'RIC, INC 8732 NW 1 19TH STREET, I3AY #I HIAI -EAH GARDENS. FL 33018 COVERAGES CERTIFICATE HOLDER �I ADDITIONAL INSURED', INSURER LETTER. MIAMI SHORES VILLAGE BUILDING & ZONING 10050 NE SECOND AVENUE MIAMI SHORES. F1.33138 tlCORn 25; -, (1/37) THIS CERTIFICATE IS ISSUED AS A MATTER bl= INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. TTSDAI..F, INSURANC CO. (A rated ) INSuaeR§- Bridgetield Employers Insurance co INSURER C. INSURER D- INSURER E- CANCELLATION AUTHORIZED REPRESENTATIVE DATE (MMIDDIYY) 6/16/10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATA THEGeOP THE ISSUING INSURER WILL ENI7gA OR TO MAIL ?P.. DAYS WRITTEN NOTICE TO THE CERTIPICAIE HOLDER NAMED TO TtlIE LEFT, BUT FAILURE TO 0O S0 SHAI.I. IMPOSE NU OBLIGATION OR I.IAOILITY OF ANY O UPON r'iE INSURER. ITS A;iSNT$ OR REPREBENTATlES. 8 ACORD CORNORATIQN 1988 NOR EXEMPT . THE LBER FROM 1778E T AC ext cnnN c E A EOL 411MUnc*. Business Name: L & H ELECTRIC INC. 8732 NW 119 ST. #01 HIALEAH GARDENS, FL 33018 Business Type: ELECTRIC CO LICENSE NO.: BL9030 Delinquency Fee: A 10 percent d each month thereafter with total NOTES: ELECTRIC CONTRACT BE DONE INSIDE BUILDING. DACE CO r COLLECTOR l 40 W FAGLER ST stFLOOR L tiIAIV,ILS FI.i31a City License dal �tn7Trr�►x 23 2009 2 3001 04440', SEE OTHER SIDE CITY OF HIALEAH ` GARDE 10001 N.W. 87TH AVENUE - HIALEAH GARDENS, FLORIDA 33016 BUSINESS TAX RECEIPT percent fee is charged for LICENSE YEAR 2009 -2010 LICENSE MUST BE EXHIBITED CONSPICUOUSLY AT YOUR PLACE OF BUSINESS . - LOCAL BOSINESS TAX; MIAMI-DADE COUNTY S`iATE OF'F.L.ORI • EXPIRES.SEPT. 3o, aoia F • MUST IIE DISPLAYED AT PLACE Ot' i it I SUANT Tfl COUNTY CODS C t H i8 ,Ntrr A BIL DO NOT FORWARD L & H ELECTRIC INC MICHAEL LOESHE PRES 8732 NW 119 ST 1 HIALEAH GARDENS FL 33018 fli 11. 11,11 7 'in 1111 11t111}��f�� FIRST -CLASS '. U.S.-POSTAGE 1 PAID - MIAMI, FL IiMrf..NO.231 DATE 9/23/2009 Issued To: MICHAEL DAVID LOESCHE 27291 SW 164 AVE HOMESTEAD, FL 33031 MANY KIND. ALL WORK SHALL